Clinicopathologic Study on 51 Cases of Prurigo Nodularis

Kim, Soo Nam; Ahn, Hyohyun

Abstract

BACKGROUND: Prurigo nodularis(PN) is a rare recalcitrant pruritic disease. Its pathophysiology is still debatable and a matter of speculation. And, there has been no large case study in Korea.
OBJECTIVE
We tried to evaluate the epidemiologic aspects in Korea, and the clinicopathologic correlates of PN.
METHODS
51 patients were included in this study. The patients were divided into atopic and nonatopic groups. All the available clinical and laboratory data including total serum IgE were collected and analyzed. 48 slides were stained in hematoxylin-eosin. For immunophenotyping of cellular infiltrate and identification of neural tissue, 10 cases of them were stained immunohistochemically. They were examined under light microscope.
RESULTS
The male to female ratio was 2.4:1. The age was varied from 3 to 64 years, averaging 36.6 years. The age of onset was varied from 2 to 64 years with two peaks in second and fifth decades. The site of predilection were the extremities (96%) and less commonly the trunk (49%). The underlying diseases were present in 23.5% of total patients. The atopic group has relatively younger age and higher total serum IgE level than non-atopic group. There was no significant difference in the recorded pathologic and immunohistopatholgic characteristics between two groups except the deep inflammatory infiltrate and dyskeratosis. There was prominent neural hyperplasia associated with vascular proliferation and inflammatory cellular infiltrate.
CONCLUSIONS
There were some epidemiologic differences from western patients. There were about twice as more male patients. Age of onset had some predilections. Atopic and non-atopic groups were different in clinical and some pathologic variables. The former was younger, had higher total serum IgE, and histopathologically, showed more pronounced neural hyperplasia.